The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) RMI COVID-19 Emergency Response Project (P173887) EAST ASIA AND PACIFIC | Marshall Islands | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 22-Jun-2022 | ISR50429 | Implementing Agencies: Ministry of Health and Human Services, The Republic of the Marshall Islands Key Dates Key Project Dates Bank Approval Date: 16-Apr-2020 Effectiveness Date: 29-Apr-2020 Planned Mid Term Review Date: 10-Jun-2022 Actual Mid-Term Review Date: 10-Jun-2022 Original Closing Date: 31-Oct-2022 Revised Closing Date: 31-Oct-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of the Marshall Islands. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1. Emergency COVID-19 Response:(Cost $2100000.00 M) Component 2. Implementation Management and Monitoring and Evaluation:(Cost $400000.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions This is the fourth implementation status and results report, covering the period from September 2021-June 2022. It includes information received during the third implementation support mission and mid-term review held from May 24-June 10, 2022. The RMI COVID-19 Emergency Response Project is part of the World Bank's COVID-19 Strategic Preparedness and Response Program using the Multiphase Programmatic Approach. Project activities have been found to continue to contribute to the readiness of the RMI and the Ministry of Health and Human Services to detect and respond to the threat of COVID-19 prior to the first case of COVID-19. Component 1 - COVID-19 Emergency Response: After project approval, Component 1 activities were consolidated into two main activities. The purchase of critical medical equipment, supplies, personal protective equipment has been fully completed. Items have been delivered to Majuro and onward to Ebeye, as agreed by GRMI. The recruitment and mobilization of surge medical/public health providers has progressed, and 11 of 28 providers are in-country, though logistical challenges persist due to global labor shortages, COVID-19 response regulations, and travel restrictions. Capacity development initiatives focused on human resources management and field epidemiologist training are progressing as planned. 6/22/2022 Page 1 of 6 The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) Component 2 - Implementation Management and Monitoring and Evaluation: Project management, and fiduciary aspects in particular, will continue to be the focus, which will be aided through an update to the Project Operations Manual. Results monitoring is steadily improving with support from the epidemiologists mobilized through the project. MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body As of June 15, 2022, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects have been restructured to include vaccine-related procurement. Total disbursements as of June 15, 2022, amount to US$3.6 billion or 84% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are thirteen (13) operations with closing dates by the end of FY22. Other 10 operations which had closing dates by the end of the FY have extended their closing dates. There are 12 operations with disbursements under 50%. Out of these 12 operations, one has not disbursed, and four have disbursed 30 percent or less. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-six (86) or 99% of projects approved are disbursing. MNA has the highest percentage of disbursements, followed by SRA, EAP, ECA and LAC, AFE and AFW. Retroactive Financing represents 26% of commitments. Country teams for operations, which have been under implementation for twelve months or more by June 30, 2022, are preparing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared early next FY. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of mobility restrictions. Bank staff are operating in a hybrid environment with some days at the office and others at home. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating 6/22/2022 Page 2 of 6 The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) Political and Governance Moderate Low Low Macroeconomic Moderate Low Low Sector Strategies and Policies Substantial Low Low Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary High High Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Low Low Other Moderate Low Low Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes To prevent COVID-19 in the RMI IN01109827 ►Number of community non-pharmaceutical COVID-19 containment strategies deployed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 2.00 21.00 8.00 Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 The indicator is a count of the physical, non-pharmaceutical containment strategies deployed. RMI reported 21 NPIs deployed, including closure of borders, border screening, community and school testing, Comments: social distancing, bingo shutdown (2020-21), etc. To respond to the threat posed by COVID-19 in RMI IN01109828 ►Total number of cases of COVID-19 reported and investigated per MOHHS protocol (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 4.00 18.00 20.00 Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 The indicator definition was discussed in the December, 2020 mission and updated to align with current Comments: MOHHS reporting requirements. To strengthen national systems for public health preparedness in RMI IN01109829 6/22/2022 Page 3 of 6 The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) ►Number of staff trained in infection prevention and control per MOHHS protocol (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 254.00 726.00 250.00 Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 Staff include health staff (regular and surge staff physicians, nurses, midwives, paramedics, lab techs and community health outreach workers) and non-health (points of entry, PSS, first responders, etc.) trained in Comments: the MOHHS IPC protocols. Intermediate Results Indicators by Components 1. Emergency COVID-19 Response IN01109830 ►First COVID-19 case reported to WHO and CDC within 24 hours of confirmation per IHR requirements (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 Submission of required WHO and CDC reporting forms according to protocols upon the confirmation of at Comments: least one respiratory specimen that tested positive for the virus that causes COVID-19 within 24 hours. IN01109832 ►Number of designated laboratories with COVID-19 diagnostic capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 3.00 2.00 Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 The MOHHS will define and regularly update the appropriate testing protocol. MOHHS will define Comments: 'diagnostic capacity' according to the testing protocol and will include human resources and the specifications of the diagnostic equipment, test kits, and reagents required for COVID-19 testing. 2. Implementation Management and Monitoring and Evaluation IN01109831 ►At least one multisectoral simulation exercise conducted with results incorporated into national COVID-19 preparedness and response plans (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 A simulation exercise will involve one or more ministries and may be related to early warning surveillance, point of entry procedures, rapid response team deployment. A real time event may also be counted, as Comments: per MOHHS decision. As of June 2022, two table top exercises, one full scale exercise, and one functional drill exercise have been carried out. 6/22/2022 Page 4 of 6 The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) IN01109833 ►Number of policies, regulations, guidelines, or other relevant government strategic documents incorporating a multisectoral approach for health emergencies developed or revised, and adopted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10.00 12.00 4.00 Date 01-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 The count will include any of these document types across sectors that are endorsed by the GRMI. The documents may be multisectoral in nature or may define sectoral responsibilities for responding to a Comments: health emergency. IN01109834 ►Percent of grievances handled according to proscribed timelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 85.00 Date 24-Apr-2020 15-Sep-2021 01-Jun-2022 31-Oct-2022 The project is using the standard grievance redress mechanism that is in place across the World Bank portfolio in RMI. Further, the Ministry of Health and Human Services (MOHHS) Facebook page and hotline are being monitored for project-related grievances. There is no numerical progress because, Comments: despite evidence of being active and available to project affected people, no project-related grievances have been recorded. The CIU and MOHHS team meet on a monthly basis to confirm the same. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173887 IDA-D6240 Effective USD 2.50 2.50 0.00 1.86 0.74 71% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173887 IDA-D6240 Effective 16-Apr-2020 24-Apr-2020 29-Apr-2020 31-Oct-2022 31-Oct-2022 Cumulative Disbursements 6/22/2022 Page 5 of 6 The World Bank Implementation Status & Results Report RMI COVID-19 Emergency Response Project (P173887) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/22/2022 Page 6 of 6